At What Cost? Trans Healthcare, Manipulated Data, and Self-Appointed Saviors

Nearly every time I speak with someone unfamiliar with the true nature of the underground madhouse that is trans healthcare, I am asked some iteration of the same question:

“Just to be clear, you still support the rights for actual trans people to get health care, right?”

Though well intended, questions like these are a redundancy that obfuscate the glaring need for a public conversation on the sorts of “healthcare” currently being offered to individuals who identify as transgender. Those who are more familiar with trans healthcare may assert that the problem with trans healthcare is simply an overabundance of leniency (not enough “gatekeeping.”) Such people may also point to the prevalence of self-diagnosis as a method for determining which individuals have gender dysphoria and should have access to hormone replacement therapy and surgeries. Though these points are well taken, they fail to contain or address the broader and systemic ideological corruption pervasive in the transgender healthcare industry. A corruption which has already begun to produce the early stages of a catastrophic outcome for the many vulnerable patients subjected to its methods.

Unfortunately for those who identify as transgender, the language of “rights” has been perverted from one that refers to an individual’s right to freedom from harmful encroachment by others to one that simply means “things people desire.” The ideology responsible for this linguistic shift demands these desires to alter the body be met, and met immediately, without regard for the many converging causes and effects of such desires both in the individual context and on the level of the broader mechanisms of society. In the context of “trans rights,” in this case specifically the “right” to cross-sex hormones and gender surgeries, this reconfiguration of language could not be more clearly subject to abuse.

Implicit in the discussion of a trans-identifying person’s “right” to cross-sex hormones and surgery is the absolute classification of all such interventions as “care.” Time and time again we hear about how “trans folks” need “life-saving care” from those who have appointed themselves to a position of activism on behalf of those inclined to seek out the medical interventions offered by the trans healthcare industry. However, there are a multitude of reasons why the unquestioning acceptance of these interventions as “care” is both ethically and scientifically flawed. It is true, and will always be true, that people who identify as transgender should receive support as well as proper, evidence-based, mental and physical healthcare. The issue is that as it stands today, the trans healthcare industry, and increasingly the institutions of the broader medical establishment (including the World Health Organization, the American Academy of Pediatrics, the American Psychological Association, and the Endocrine Society, among others), have broken away from the traditional standards originally set by rigorously developed medical ethics and the scientific method.

I recognize there have been other instances where Western academic and medical establishments have failed to live up to their commitment to rigorous ethical standards and scientific methods. The so-called “replication crisis” in the social sciences is one such example. However, the recent shift to the “gender-affirmative” approach for the treatment of the transgender identifying and gender dysphoric population is unique for two reasons. The first is the speed with which the shift occurred; the second is that the shift was implemented for entirely ideological and political reasons.

A major hurdle for those who advocate for the “gender-affirming” approach to medicalization over the past decade has been producing any scientific results that actually support their theories. Luckily for them, and unfortunately for everyone else, this hasn’t held back their progress much. However, as awareness of the drastic shift to the “gender-affirmative” model has grown, pressure has also begun to mount from those wishing a return to rigorous ethical and scientific methods. For this reason, there is now a delightful assortment of “scientific” studies that purport to justify, if not “prove,” the necessity of unregulated distribution of cross-sex hormones and irreversible surgeries to anyone who calls themselves transgender or even “nonbinary.” Such studies are hurled with rapid succession, Ivy League stamp of approval and all, at anyone who questions the new “gender-affirmative” doctrine of “care”. Depressing as this is to witness for those of us who were subjected to “gender-affirming” “life-saving” “care” (and are currently facing the consequences), the actual content of these studies provide a valuable tool to demonstrate the true morally destitute and scientifically farcical nature of current trans healthcare.

One such study recently came to my attention and perfectly illustrates the bad faith in which “gender-affirmative” “care” is administered. It was conducted by the Yale University School of Public Health in 2019 by Associate Professors John Pachankis and Richard Bränström. In the study, Panchankis and Bränström analyzed Swedish data on patients who had undergone various gender-related surgeries and found that these patients had an average of an eight percent decrease in mental healthcare consumption (therapy, prescriptions, hospitalizations) per year following their last surgery. “No longer can we say that we lack high-quality evidence of the benefits of providing gender-affirming surgeries to transgender individuals who seek them,” said Pachankis in an article still available on the Yale University website. Soon after its publication in the American Journal of Psychiatry, professionals in medicine and academia raised concerns including (but certainly not limited to) the study’s failure to provide a control group and the overt misprinting of statistical data. Once these concerns were raised to light, the authors retroactively compared these outcomes in mental healthcare visits for patients who had undergone surgery to patients who had not, and found, “no advantage of surgery in relation to subsequent mood or anxiety-related health care visits.” This is a complete reversal of the original finding. In short, a study that co-author Pachankis hoped would “help influence policymakers” was only able to recommend “gender-affirming” surgery when it abandoned the very basics of the scientific process. Once the scientific process was restored, and the study was made subject to proper rigor, the recommendation of “gender-affirming” surgery was removed. The journal has since published a correction.

Why would two career academics in the field of public health research conduct a study that they clearly would have known was flawed and whose conclusions were deeply dishonest? If they genuinely believed a “gender-affirming” approach to the distribution of invasive surgeries was one of compassionate and medically necessary care, why would they not have conducted a rigorous and honorable study into the effects of surgery on the mental well-being of transgender patients? Why, if cross-sex hormones and gender surgeries are “life-saving” healthcare, does nearly every study into the efficacy of these medical interventions, as well as into detransition, take elusive and manipulative measures to reach fraudulent conclusions that support a pre-existing ideological conviction?

The answer is, of course, because it’s not really compassionate and evidence-based care. It’s not a life-saving panacea for any unfortunate soul who has come one way or another to develop an incongruence between their self-perception and their biological reality. It is in most cases (with the exception being perhaps the rare, emotionally stable adult with a realistic understanding of their biology and the little known risks of medical transition) harmful collusion on the part of trusted professionals with a patient’s torturous psychological condition and enables a pattern of thinking and behavior that exponentially increases psychological and physical suffering down the road. Even in the cases of those who do not desist or detransition from their trans identity, the long term health effects are showing, in the small population of transgender adults who have been transitioning for multiple decades, to have the capacity to be quite disastrous.

Truly compassionate, life-saving care would be to take an individualized approach with each patient and tend fully and as non-ideologically as possible to the mental, emotional, and physical wellness of the entire human being. Compassionate care would be to help the sufferer comprehend themselves and the root of their distress. Compassionate care would be to devote the resources provided to us by the unprecedented development of modern science to understand what gender dysphoria actually is and how best to help those who have it or believe they have it. Compassionate care would be noticing the sweeping demographic change and exponential increase in those seeking to medically transition in the last seven years and inquire openly into what is causing it. “Care” is not lying to people. “Care” is not laundering ideology as scientific thought. “Care” is not creating a suffocating miasma around the field that silences and punishes practitioners who want better for patients.

Do not ask if it is a “right” for a vulnerable person to be an unwitting guinea pig for experimental, dangerous, and irreversible medical interventions offered by ideologues who have anointed themselves as saviors through tactics of bullying and deceit. Instead, ask if activist practitioners and researchers have a right to abuse the reverence we hold for scientific and medical credentials as they lie, cheat, manipulate, and abuse a vulnerable population of transgender identifying and gender dysphoric people, a vulnerable population that the trans rights activists themselves acknowledge holds many times the mental health diagnoses as does the general population.

So, at last, do I support trans people’s “rights” to “care?” I do, and I am quite passionate about it. However, what is currently being passed off as “trans rights” and “care” is a violation of the eternal and immutable right of the human being.

This article was originally published on Medium.